I get nervous when I talk to people. I have a naturally high baseline anxiety level—it’s just how I’m wired—and I know this is a big part of my interpersonal nervousness. But part of it is also a learned anxiety because from long experience I know there’s a high likelihood that when I open my mouth, I’m going to be misunderstood. My palms get sticky, pit stains bloom, and my heart flutters, especially when I’m talking to teachers, plumbers, hotel concierges, dental hygienists, my in-laws, massage therapists, other parents, telephone solicitors—
Oh, the long history of mutual misunderstanding I have with doctors.
I try to give them the benefit of the doubt. They’re human; they’re busy. Yes, I’m paying them (or my insurance is), but there are myriad reasons they’re not necessarily able to give me their full attention. And since I’m the common thread between all of these doctors and all of this misunderstanding, I’ve racked my brain to think of what I must be doing to contribute to the miscommunications, and over the years I’ve modified my approach.
Following the advice of websites and insurance company publications, I take in my written list of questions (prioritized by importance), so I can hit the high points and don’t flail about trying to remember what I was supposed to ask about. In addition, I do deep breathing exercises in the waiting room, tap into self-hypnosis techniques, and do lovingkindness meditation just for good measure, and still I leave the office feeling rushed and befuddled.
Sometimes it’s like they physically can’t hear me, so I try to speak up. Other times, they seem frustrated or annoyed when I ask them questions, which I read as defensiveness (and which doesn’t do much to decrease my anxiety). Sometimes they have a treatment recommendation in mind before they’ve asked me what I’ve already tried. Example:
doctor: “You’ll lose weight easier if you add weight training to your exercise routine.”
me: “I do weight training every morning.”
doctor: “Well, you should do upper body, not just lower body.”
me: “I do upper bo—“
doctor: “Okay, open your mouth and stick out your tongue!”
And still other times, it’s as though I’ve calmed myself so much that I can’t convey with my voice the importance of what I’m trying to say. Several years ago, our pediatrician gave me his cell phone number with the instruction that if my newborn’s temperature went above 102, I was to call him immediately. My voice mail to him went something like this: “Um, so you said to call if my son’s temperature went above 102, and it went up to 102.5, and something weird happened that I think might have been a seizure. So, could you call me back?”
He didn’t call back, and when I asked him about it at our appointment a few days later, he said he didn’t call me back because I didn’t sound concerned on the voice mail. “If I’d known it was that serious I would have called you back,” he said.
I had absolutely no idea what to do with this feedback except to think back to all of those courtroom shows I used to watch and worry that if I ever had to defend myself in court, I wouldn’t show enough emotion and the jury would convict me of whatever horrible thing I’d erroneously been accused of. (Have I mentioned I have a tendency towards anxiety?)
My new doctor has this online patient portal thing through which I can ask the office questions about treatment in writing.
In writing! O frabjous day! I’m much less anxious when I write! I’m even somewhat intelligible at times! Surely this would solve my communication issues with doctors!
With much optimism, I responded to a message my doctor’s office sent about some lab results. I responded with seven questions. Yes, this is normally way too many questions for an e-mail, but it’s how many I had. And I was writing to a medical professional, with the straight A’s and the years of schooling and the 100-hour a week residencies. Surely this person could handle a seven-question e-mail. I even numbered them for her convenience.
A couple of hours later, I got her response. It was five lines long with one short sentence per line. It answered four questions, but only two of those were questions I’d asked. I wondered if she had a select-a-response like customer service reps use, but that didn’t seem like a very charitable thought so I pushed it aside.
“Okay,” I thought. “I asked too many questions that first time. What is the most important question out of those seven?”
I crafted another e-mail, highlighting just the one question and admitting that I was feeling confused. I did not say that I was feeling confused because she wasn’t answering my questions because I was trying hard not to be passive aggressive.
About an hour later, I got another response which still didn’t answer my question. My one question. And it was still written in five lines with just a few words per sentence. I wondered if the portal had some Twitter-like limit on how many characters she could use in her answer or if maybe she thought I could only read at a fifth grade level.
Undaunted, I wrote back again, this time rephrasing something she had written in her most recent e-mail and asking for clarification, hoping to lead her to actually answer the question I had asked twice already.
Her response this time was only three lines long and not only didn’t answer my question, but contradicted something she had written in her first e-mail. And then she told me to make an appointment with the nurse practitioner because I have so many questions.
So, I gave up.
I suspect avoidance isn’t the best course of action here (I’m going to have to talk to a doctor at some point, even if I don’t talk to this one again), but I’m not sure how else to prevent this kind of Kafkaesque exchange.
Is it really just me, or do other people have trouble communicating with medical professionals?